Some of the resources described below for doctors would also be of interest to patientsand are a good way to understand the communication challenges from the physician's side. But there are many resources specifically for patients. The following are just a few of the available resources

Essential advice on how to make the most of physician visits is available from many sources. For example, the following is adapted from advice given by Park Nicollet Health Services in Minnesota:

Write down your most important concerns.Before your visit, review all your symptoms, including when they started; the history of the problem, including whether you've had the problem before; and any treatments you have tried. List these things in order of importance, so you will be sure to get your most pressing concerns answered.

Bring related records.If you have information about drugs you use, allergies or other health problems, bring these records along if you are seeing a doctor for the first time. If your appointment is with a doctor you've been with for a while, be sure to let him or her know what over-the-counter remedies you are using and whether you are taking medicine prescribed by another doctor.

Be brief and clear.As you describe your symptoms to your doctor, avoid vague statements, such as "I've been feeling sick lately." Be specific: "I've had a headache and nausea for the past week, and I don't know what's causing it."

Take notes.Even if you can't write down everything you hear, an outline of the discussion will dramatically increase your memory of the information. Take some time immediately after the visit to fill in other details you remember about the discussion. It also may help to talk your visit over with a friend or family member soon afterward.

Ask for information that is organized.Studies on communication show that understanding improves when information is well organized. Ask your doctor to put information into categories, such as what is wrong, what tests you may need, what treatments are available, and what you must do.

Ask for explanations.When in doubt about a term your doctor uses, ask. A good way to ensure that you understand is to restate what you believe the doctor has told you. Then if you have misunderstood something, your doctor can explain it again.

The following is adapted from advice given by the National Institutes of Health

Be honest: It is tempting to say what you think the doctor wants to hear; for example, that you smoke less or eat a more balanced diet than you really do. Or that you take your medication when you really don't. While this is natural, it's not in your best interest. Your doctor can give you the best treatment only if you say what is really going on.

Stick to the point: Although your doctor might like to talk to you at length, each patient is given a limited amount of time. To make the best use of yours, stick to the point. Give the doctor a brief description of the symptom, when it started, how often it happens and if it is getting worse or better.

Ask questions: Asking questions is key to getting what you want from the visit. If you don't ask questions, your doctor may think that you understand why he or she is sending you for a test or that you don't want more information. Ask questions when you don't know the meaning of a word or when instructions aren't clear. You might want to say, "I want to make sure I understand, could you explain that a little further?" It may help to repeat what you think the doctor means in your own words and ask, "Is this correct?" Also, if you are worried about cost, say so.

Share your point of view: Your doctor needs to know what's working and what's not. He or she can't read your mind, so it is important that they hear from you.

Plan to update your doctor: Think of any important information you need to share with your doctor about things that have happened from your last visit. You can write them down on a list as you notice them. Let your doctor know about any recent changes in the way your medication affects you.

Your doctor may ask how your life is going. This isn't just polite talk or an attempt to be nosy. Information about what's happening in your life can be useful medically. Let the doctor know about any major changes or stresses in your life like moving, changing jobs, a loved one's death, change in relationship status, etc.

Remember, doctors don't know everything, and even the best doctor may not be able to answer some questions. There still is much that isn't known about the human body and disease. Most doctors will say when they don't have the answers. If a doctor regularly brushes off your questions or symptoms, think about looking for another doctor.

A wide variety of resources to help patients communicate can be found at www.mercksource.com. Patients can begin with a few brief videos done by Dr. Marie Savard, at MerckSource. Topics of these videos include

Getting started.

Recording your medical history

Preparing for your doctor's visit

Building you medical records

Keeping track of medicines and allergies

Each of these videos is accompanied by forms that patients use to prepare and keep information to improve communication. Below is a list of the forms, which you can see and print out now by clicking on the form name

Patients will find much valuable advice on the website of the U.S. Agency for Healthcare Research and Quality (AHRQ). The following is a list of articles by Dr. Carolyn Clancy, the agency's Director. You can see and print out any article by clicking on the article's title:

Many sources stress the desirability of having a friend or family member be with the patient to help the patient ask questions and take notes on what is said. More broadly, there is increasing awareness of the importance of having family and friendsand a whole communityinvolved in each patient's care.